Vet News

April 12, 2017

Effusion Analysis (Part 2)

  Effusion Evaluation: Last week we talked about how to determine if your effusion was septic. This week, let’s have a look into further evaluation of effusion samples. If the effusion is haemorrhagic, here are some things to look out for. Real or iatrogenic origin: Blood rapidly defibrinates in cavities so if it clots then it is iatrogenic If it swirls during collection it is more likely to be iatrogenic Is it acute or chronic? Compare PCV/TP to peripheral, if sample PCV/TP = peripheral blood PCV/TP then a recent bleed is most likely the cause Always run a PCV/TP on haemorrhagic […]
April 12, 2017

Making Sense of Effusions (Part 1)

  Is Your Patient Septic? Interpreting effusion samples can be confusing. Try to think of effusions as if you were collecting a blood sample. Many of your in-clinic diagnostic tests that apply to blood samples also apply to effusions, such as PCV/TP, smears, glucose, lactate, potassium, creatinine and bilirubin. It is not enough to only check the protein concentration of the effusion, then classify it as either a transudate, modified transudate or exudate and leave it at that. There is more information left to extract from that sample! Determining if an effusion is septic can be a challenge, here are […]
February 21, 2017

Pulse Oximetry! Know it’s Limitations.

Pulse oximetry is very useful diagnostic and monitoring tool that is now commonplace in veterinary clinics. It measures the percentage of hemoglobin that is saturated with oxygen, and is an indirect measure of arterial oxygen levels. However, here are several important points that can help you understand the limitations of pulse oximetry: Causes for false readings: Falsely low readings: Motion artefact Peripheral vasoconstriction/low tissue perfusion from hypothermia or shock Pigmentation of mucous membranes Thick hair coat Falsely high readings: Hemoglobin abnormalities (i.e. carboxyhemoglobin and methemoglobin) Pulse oximetry can give us a false sense of security: we hold on to the […]
January 16, 2017

Don’t Rush: A Systematic Approach To X-rays

  One of my responsibilities in our emergency hospital is the training and mentoring of veterinarians new to the field of emergency and critical care. A common area that I have found where clinicians request more training is radiographic interpretation. When I review radiographs and I find pathology that was missed it is more often due to a lack of systematic approach to reviewing a radiograph rather than experience or knowledge of that clinician. There is of course, no one set way you should go about interpreting a radiograph, whatever the method the entire radiograph should be assessed not just […]
December 30, 2016

The Dangers of Casts and Bandages

    Casts and bandages are frequently used to treat orthopaedic conditions, especially in situations where clients have financial constraints thus ruling out surgical treatment. However, these techniques have an extremely high probability of complications that include: Malunion, delayed or non-union. Fracture disease, which refers to joint stiffness, muscle atrophy, and disuse osteopenia associated with prolonged casting. And most commonly, soft tissue injury ranging in severity from mild dermatitis, pressure sores to sepsis and avascular necrosis of tissues. Although avoidance of using coaptation techniques is recommended, very stringent case selection may help to reduce the risk of complications occurring. If […]
December 12, 2016

Urinalysis – The Neglected Test.

Urinalysis is an important diagnostic tool in veterinary practice. It is indicated for any patient that presentations with polyuria or urinary tract signs, but also a necessary test to perform in conjunction with serum biochemistry. Why do some clinicians fail to perform urinalyses even when they are indicated? Some reasons include: Clinicians don’t see the importance of obtaining a urine sample. The difficulty in obtaining a sample in some situations. The patient may not want to void. No access to an ultrasound for a guided cystocentesis. Patients may not urinate upon bladder expression. However, it is important that clinicians make […]
December 12, 2016

Blood Smears – Make Them A Routine Test!

  Blood smear evaluation is an often overlooked but a very important aspect for in-house haematology. With the advancement in haematology analysers that can now detect reticulocytes and even band neutrophils, some practitioners are beginning to rely solely on the numerical data alone in evaluating the patient’s blood. The art of blood smear interpretation is on the decline. However, it is an extremely valuable skill that needs to be practiced and perfected and should be part of every in-house haematology. What are the benefits of understanding blood smears? Identifying of a regenerative response, looking for reticulocytes (polychromatophils) Looking for the […]
October 9, 2016

Dog Bite Wounds – The Tip of Iceberg!

Dog bite wounds are one of the most common presentations both in general and emergency practice, and they can often be challenging cases. Once you have stabilised the patient, it is time to go speak to the client. Here is the most important point that you need address: The injuries you see are just the “Tip of the Iceberg’’. It can be helpful to draw pictures to let them know that a small penetrative puncture wound can often be masking a horrific injury underneath, especially in big dog on small dog bite wounds, where the small dog is often picked […]
September 26, 2016

Fluid Therapy: Twice Maintenance Just Isn’t Good Enough!

Fluid therapy is a topic that sometimes gets overlooked by veterinarians, partly because there is a misconception that developing fluid plans can be very difficult. However, if you keep it simple, you can develop a tailored fluid therapy plan for you patient that is much better than a blanket ‘twice maintenance’ rate. There are 4 basic components to a fluid therapy plan that you need to think about: Perfusion deficit Hydration deficit Maintenance requirements Ongoing losses Perfusion deficits need to be corrected immediately. Start with a 10mls/kg IV fluid bolus of buffered crystalloids and repeat as necessary to shock volumes […]